Acceptance and Commitment Therapy for Body Dissatisfaction: A Systematic Review and Meta-Analysis

Introduction

Body dissatisfaction (BD) is increasing internationally and is associated with a range of physical and psychological negative outcomes, including eating disorders (ED). As a result, there is a great need to identify treatments that reduce BD to intervene and prevent these outcomes. Acceptance and commitment therapy (ACT) has been employed for body image and weight concerns. However, there is limited data on the efficacy of ACT in reducing BD.

Objective

To evaluate the efficacy of ACT on measures of BD in those with or without a diagnosable ED.

Methods

A systematic review and meta-analysis were conducted, including 12 studies that utilized individual, group, or online self-help ACT interventions targeting BD (N = 825; analyzed at the end of interventions N = 741).

Results

ACT was efficacious in decreasing BD compared to control groups with a significant medium effect size in the full sample (k = 12, g = 0.556, 95% CI = [0.35, 0.77], p < 0.001, I² = 45.61). The strongest effect sizes were produced by subgroups of participants who were at high risk for EDs (k = 6, g = 0.631, p < 0.001), and those who received ACT via online self-help forums (k = 3, g = 0.563, p < 0.005). A majority of studies (75%) had low to medium risk of bias. The mean dropout rate across ACT interventions was 23.51%.

Discussion

These results demonstrate that ACT is efficacious in BD reduction, particularly in those with high BD, at risk for developing EDs, and in the form of online self-help. ACT, therefore, shows potential as a prevention program, in addition to augmenting existing multidisciplinary treatments for ED patients. Due to limitations of this meta-analysis, further research should investigate a greater volume of large-scale trials from diverse populations across the globe.